Benchmarking Skeleton-based Motion Encoder Models for Clinical Applications: Estimating Parkinson's Disease Severity in Walking Sequences

Parkinson's Disease is a degenerative disorder for which precise motor assessment is critical. This study investigates the application of general human motion encoders trained on large-scale human motion datasets for analyzing gait patterns in PD patients. Although these models have learned a wealth of human biomechanical knowledge, their effectiveness in analyzing pathological movements, such as parkinsonian gait, has yet to be fully validated. We propose a comparative framework and evaluate six pre-trained state-of-the-art human motion encoder models on their ability to predict the Movement Disorder Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS-III) gait scores from motion capture data. We compare these against a traditional gait feature-based predictive model in a recently released large public PD dataset, including PD patients on and off medication. The feature-based model currently shows higher weighted average accuracy, precision, recall, and F1-score. Motion encoder models with closely comparable results demonstrate promise for scalability and efficiency in clinical settings. This potential is underscored by the enhanced performance of the encoder model upon fine-tuning on PD training set. Four of the six human motion models examined provided prediction scores that were significantly different between on- and off-medication states. This finding reveals the sensitivity of motion encoder models to nuanced clinical changes, emphasizing their potential utility in clinical settings. It also underscores the necessity for continued customization of these models to better capture disease-specific features, thereby reducing the reliance on labor-intensive feature engineering. Lastly, we establish a benchmark for the analysis of skeleton-based motion encoder models in clinical settings. To the best of our knowledge, this is the first study to provide a benchmark that enables state-of-the-art models to be tested and compete in a clinical context. Codes and benchmark leaderboard are available at code.